EFFECT OF AUREOMYCIN TREATMENT OF STREPTOCOCCAL SORE THROAT ON THE STREPTOCOCCAL CARRIER STATE, THE IMMUNOLOGIC RESPONSE OF THE HOST, AND THE INCIDENCE OF ACUTE RHEUMATIC FEVER

Abstract

A total of 1,009 patients with exudative tonsillitis or pharyngitis, predominantly streptococcal in etiology, was treated with aureomycin hydrochloride. A control group of 1,035 patients received no aureomycin. An illness classified as definite or possible rheumatic fever subsequently developed in 20 patients who had received aureomycin and in 29 who had received no treatment. Data collected on rheumatic subjects indicated that when the interval between the onset of the observed attack of exudative tonsillitis or pharyngitis and the onset of rheumatic fever exceeded 35 days, an intervening streptococcal infection had occurred. Five patients in the treated group and 20 in the control group developed rheumatic fever within a 35 day interval. These data indicated that aureomycin therapy greatly reduces the subsequent occurrence of rheumatic fever. Aureomycin therapy was also found to eradicate the streptococcus from the oropharynx in a large number of instances and to inhibit the formation of antistreptolysin. The degree of inhibition of antistreptolysin formation was shown to correlate with the eradication of the streptococci from the oropharynx. When bacteriologic relapse occurred following cessation of aureomycin therapy, the degree of inhibition of antistreptolysin production was low. Aureomycin therapy of streptococcal infections was compared to penicillin therapy of such infections. It was shown that penicillin was more effective in eradicating streptococci, decreasing antistreptolysin formation, and preventing rheumatic fever. Penicillin, therefore, is the drug of choice.